Sex Therapy with Former Cult Members
ICSA Today Vol. 8 No. 3, 2 -5
The vilification and control of sexuality in high-demand groups (HDGs, or cults) is well-documented and often cited as one of the defining characteristics of cultism in general. Nowhere is cultic sex negativity more pronounced than in the treatment of sexual minorities.
The term sexual minority has generally been used to refer to people who identify as lesbian, gay, bisexual, or transgendered. I would argue that sexual minority can be applied in a much broader sense to refer to anyone outside the accepted norms of sexual interest (who—or what—one finds sexually attractive at any given time), sexual orientation (who one finds attractive in general), sexual identity (how one identifies one’s sexuality), gender identity/orientation (with which gender, if any, one identifies) and gender expression (the gender, if any, one expresses in public).
Moreover, there are lifestyles that might be considered those of a sexual minority. These include everything from nonmonogamy (e.g., polyamory) to pansexuality (fluid sexual interest depending on the individual, regardless of the gender) to asexuality (little to no sexual interest).
For the purpose of this article, normative sexuality refers to those who identify as heterosexual (“straight”), cisgendered (one’s gender identity matches one’s anatomy at birth) and monogamous (one’s sexual behavior is restricted to one partner), and who typically engage in sexual activity within the bounds of a committed relationship or marriage. In my work as a sex therapist, I also usually define sex as any activity that involves genital contact of any kind; thus, having sex can refer to manual, oral, anal, and “rubbing up against” genital contact and also to vaginal-penile intercourse.
Many, but certainly not all, people coming out of cults have experienced an array of sex-negative messages, at times implicit but more often explicit in the cult’s ideology or theology. By sex-negative, I am referring to an attitude toward nonnormative (and at times even normative) sex that induces or is associated with guilt, shame, humiliation, or a combination of these. In some religious cults, shame is greatly exacerbated by the attachment of nonnormative sexual feelings, thoughts, and behaviors to spiritual ruination (e.g., demonic possession) that are claimed may even damage the spiritual health of ancestors and also future offspring (Unificationist theology is a prime example of this perspective). In therapy cults, sexual shame is often associated with psychodiagnostic labeling and condemnation (e.g., “acting out” or “sexual addiction”), while in some political cults sexual shaming can be tied into a highly rigid self-condemnation for being “bourgeois,” “sexist,” “classist,” and so on.
In a small number of cults that coerce sexual behavior, a member’s failure to engage in prescribed but unwanted sexual behavior can be used to induce guilt and shame in that member. The Rajneesh group was infamous for making members “confront” their “sexual hang-ups” by engaging in unwanted, often nonnormative sex, for example. Other groups, often referring to themselves as “therapeutic,” demand either rigid abstinence from or coerced engagement in sex to supposedly “heal” from past sexual trauma.
Whether they are demanding unwanted sexual behavior or stifling natural sexual development and expression, cultic groups have this in common: They demand that one conform to an external and rigid set of rules or guidelines, irrespective of one’s history or variation, as opposed to supporting an individual exploration of one’s unique sexuality (which can and often does involve nonnormative sexual/gender identities, orientations, interests, and behaviors).
Sexuality Counseling and Therapy With Former Members
In working with former (and a few current) cultists around sexual issues, I typically find it important to initially discuss a few ground rules, the first involving how to determine what will be the ultimate basis for our discussion about or work on sexuality. I am generally very open about my training and orientation: I am committed to the science of sexuality (technically referred to as sexology). My opinions and interventions are based on this evolving science, with some aspects of sexuality now being accepted as fact (such as the fact that same-sex sexual behavior, or homosexuality, is a natural variation that exists in hundreds of animal species), while other aspects (such as whether homosexuality in human males has a primarily pre- or postnatal cause) are still being actively studied. Many of my clients, including former members of Bible-based cults, correctly associate a biologically based view of homosexuality with a more general belief in evolution, and that perspective in and of itself can be a difficult bridge to span. Some former members of therapy, political, and New Age groups, although they are no longer actively involved in their groups, nevertheless maintain a belief in constructivism, which postulates that most of human thought, belief, and behaviors are not inherent, or part of human nature, but are instead socially constructed and can therefore be deconstructed. They reject the notion of homosexuality having a primarily biological, hormonal, or neurological basis, for example, and instead insist that all sexual interests, orientations, and behaviors are a matter of individual choice. Many of these clients are bright and well-educated; they are aware of the growing research on sexual fluidity and cite these studies to reinforce the constructivist beliefs they learned in their cult.
As a therapist, I am faced with an ongoing conflict in this context: To what degree, if any, do I confront not just the group’s cultic processes (often already studied and at least partially accepted if my client is a former member), but also the group’s cultic philosophy, which is often still ingrained in the former member and is almost always intricately intertwined with the former member’s sexuality. In the interest of honesty and building trust, I feel it is important to state sooner rather than later that I approach sexuality primarily as a scientist and sometimes as a historian/sociologist, and not as a moralist, philosopher, or theologian.
What I typically explain is that, in practice, a scientific approach means I strongly encourage “less judgment, more curiosity”1 when it comes to discussing sex and sexuality. To be less judgmental and more curious means being open to any and all sexual thoughts, feelings, interests and (at times) behaviors;2 that approach can often bring us back to discussing the conflict between a scientific vs. a nonscientific (i.e., moralistic) approach. Research on human sexuality tells us that, with rare exception, awareness of the unwanted aspects of one’s sexuality is necessary for understanding, growth, and, for those who desire it, self-control (Eichel, 2014). The nonscientific view in many cultic belief systems is typically that the unwanted aspects (by the cult, the member, or both) of one’s sexuality are evil or demonic, and must be actively and vigorously suppressed. So even talking about nonnormative sexuality can be a highly conflicted activity.
Ultimately, I am a pragmatist. I believe what works is what is usually best. A recent client,3 although physically no longer involved in her fundamentalist Christian sect, nevertheless maintained a very literal belief in her former church’s interpretation of the Bible. She was struggling with same-sex attraction, which she considers sinful. Nevertheless, the fact that she sought therapy obviously implied that suppression of her sexual feelings had not been entirely successful. She slowly began to consider the possibility that one can be a deeply committed Christian and at least be nonjudgmental of one’s same-sex attractions (without acting on them); she agreed to research this possibility on the Internet. She had an opposite-sex fiancé with whom she had not been fully sexual; she had explained to him that this limitation was because of her faith, when in fact it was largely because of her lack of sexual attraction to him. She eventually got to the point where she could stop suppressing her feelings and accept her same-sex attraction to others. However, she and I agreed to take a break from therapy for now because the next step (which might involve ending her engagement) is too frightening for her at this time. With current and former members of cults, this form of on-again, off-again therapy, which I refer to as brief intermittent developmental therapy, or BIDT (Eichel, 2002, 2016), is quite common.
Sexual Acting Out, Reenactment, and Addiction
Some former members, and especially those born or raised in high-demand groups, react to years of sexual repression or suppression by engaging in the other extreme: intense and even hyperactive sexual behavior (what some call hypersexuality or even sexual addiction4). Because many associate the term addiction with an inability to control, mental illness, the need for a spiritually based 12-step program, or just plain immorality, I do not refer to sexual addiction or use any other judgmental terminology. For some, especially gay men and women who have experienced significant shame and oppression in their groups, a period of sexual hyperactivity is fairly common and can even be highly productive. In therapy, I have found that firmly maintaining a neutral and nonjudgmental stance—even with highly risky behaviors (e.g., unprotected sex)—is often the only way I can facilitate real openness and honesty in my clients, and that is the single most crucial element for growth. It is only when my clients realize they can trust that I will remain neutral and nonjudgmental that I can broach the topic of sexual health and prevention of disease and pregnancy. This approach, called harm reduction, is commonly employed in addictions counseling and has been empirically validated as an effective approach to dealing with potentially harmful behaviors when clients are not ready or unwilling to cease engaging in them altogether (Hunt, 2016).
Treating Sexual Trauma
Many former cult members have experienced, directly or vicariously, sexual abuse, trauma, or exploitation in their groups. Those born or raised in cultic environments seem particularly vulnerable to these harmful experiences. If a client is currently experiencing sexual abuse or exploitation, the therapist needs to be familiar with his potential legal obligations in that situation. In Delaware, for example, I may be required to report a health professional (such as a physician or a therapist) who is sexually exploiting or has sexually exploited a patient;5 reporting requirements when the perpetrator is a clergyperson are less clear. Similarly, some states may require a therapist to report an adult caretaker’s prior sexual abuse even if the victim is not a minor and is no longer under the care of or even in contact with that adult.
However, assuming I do not have to report the perpetrator of sexual abuse, helping my client face and deal with her abuse is often (but not always!) ultimately necessary for her to recover or achieve healthy sexual functioning. Growing up in a cultic environment of secrecy and even conspiratorial complicity often complicates this healing process. Victims/survivors of cultic sexual abuse not only feel shame; they often struggle with the gaslighting6 they experienced in the group.
It is bad enough when a family member denies the reality of a child being sexually abused or exploited; imagine the degree of harm that can occur when the denial of reality and “crazy-making” comes from an entire religious or political community. Again, this is especially true of people born or raised in cultic groups. Some former members may have felt they were in love with their perpetrator(s), or had been spiritually/psychologically special or chosen. Furthermore, in my clinical work, I have known several former members who, at the time of their exploitation, experienced affection/connection, intense arousal, and even great sexual pleasure while in the control of their perpetrator(s). Even just admitting such responses to oneself can be an excruciating, even traumatic, experience. Such experiences can greatly complicate sexual recovery and experiences in the present, and can be a cause of both avoidance of sexual feelings and experiences (sexual anorexia) and hypersexual behaviors. My strong tendency is to assist my clients in finding meaning in their sexual experiences. For some, that may mean feeling in control, or experiencing the joy of choosing to engage in sexual acting-out behaviors, even when those behaviors have harmful consequences.
When working with former members who have experienced sexual trauma, I cannot emphasize enough the importance of pacing. For some individuals, the healing process will take many years and possibly several therapies or therapists. Some clients, especially those with cultic backgrounds that included pseudotherapy, quasi-therapy, or other coercive forms of psychological interventions in the guise of healing, may press for quick resolution and overly intensive treatments. Long ago, Dr. Linda Dubrow-Marshall and I noted that, in their quest to heal from intrusive and overly intensive “healing” programs, many former New Age cult members are ironically attracted to intense weekend workshops and retreats (Dubrow-Eichel & Dubrow-Eichel, 1988). On the one hand, this is understandable; nobody wants to be patient when suffering. But years of clinical experience and research has taught us that good treatment almost always involves learning to tolerate ambiguity and uncertainty. As many trauma specialists have noted, “you have to go slow to go fast” (Walters-Broadway, 2012).
As I learned and developed my personal style as a sexuality counselor/therapist, there was much in my own past I had to confront and reexamine. I have written in some detail about my own process elsewhere (Eichel, 2014); I believe the best path to becoming an effective sex therapist is through the rigorous and extensive training regimen required by the American Association of Sexuality Educators, Counselors and Therapists (AASECT) to earn certification as a sex educator, counselor, or therapist (CSE, CSC, and CST, respectively). That process begins with a Sexual Attitudes Reassessment (SAR) course that typically lasts 2 days and involves being exposed to a very broad range of sexual beliefs and behaviors, and then processing one’s reactions to this material. The goal is to develop a sex-positive style that is consistent with one’s personal values. In my work, I accept the definition of sexual health adopted by the World Health Organization (WHO):
Sexuality is a central aspect of being human throughout life and encompasses sex, gender identities and roles, sexual orientation, eroticism, pleasure, intimacy and reproduction. Sexuality is experienced and expressed in thoughts, fantasies, desires, beliefs, attitudes, values, behaviours, practices, roles and relationships. While sexuality can include all of these dimensions, not all of them are always experienced or expressed. Sexuality is influenced by the interaction of biological, psychological, social, economic, political, cultural, legal, historical, religious and spiritual factors….
Sexual health is a state of physical, emotional, mental and social well-being in relation to sexuality; it is not merely the absence of disease, dysfunction or infirmity. Sexual health requires a positive and respectful approach to sexuality and sexual relationships, as well as the possibility of having pleasurable and safe sexual experiences, free of coercion, discrimination and violence…. (WHO, 2002)
For me, sex positivity incorporates the WHO definition and guides my work. The starting point in my work is always that sex is good and healthy, and has multiple purposes and meanings. I seek to assist my clients in developing their own, independent set of attitudes, values, and meanings; I believe it is vital that therapists provide a great deal of nonjudgmental space within which clients can explore their sexualities along with the influence their cultic experiences may or may not have had on them.
 “Less judgment, more curiosity” is from a bumper sticker that is popular among members of the American Academy of Psychotherapists.
 The exception is sex offenses, such as the sexual engagement of children or minors. Most states and jurisdictions mandate that such behaviors be reported, and I always mention that requirement in my standard first-session discussion of the limits of confidentiality.
 I am changing identifying information to protect the client’s privacy.
 For a variety of reasons, I eschew the term sexual addiction in favor of more accurate terms, such as compulsive sexual behavior, hypersexuality, or even sexual compulsivity.
 I am highly ambivalent about this law as it pertains to past sexual exploitation because I believe it is potentially harmful to my current client for reasons that are too complex to discuss in this article.
 The term gaslighting refers to a film noir about a husband who develops and carries out a plan to make his wife believe she is going insane, in order to ultimately get her to commit suicide so he can inherit her wealth. In general, the term refers to manipulating another by psychological means to cause that person to question her own sanity.
Dubrow-Eichel, S., & Dubrow-Eichel, L. (1988). Trouble in paradise: Some observations on psychotherapy with new agers. Cultic Studies Journal, 5, 177–192.
Eichel, S. (2002). Saying good-bye to the guru: Brief intermittent developmental therapy with a young adult in a high demand group. In S. Cooper (Ed.), Casebook of brief psychotherapy with college students (pp. 153–170). Binghamton, NY: Haworth.
Eichel. S. (2014, Spring). A sex therapy odyssey. Voices: The Art and Science of Psychotherapy, 181, 5–12.
Eichel, S. (2016). Counseling former cultists: The brief intermittent developmental therapy (BIDT) approach. International Journal of Cultic Studies, 7, 1–14.
Hunt, N. (2016). A review of the evidence-base for harm reduction approaches to drug use. Retrieved from https://www.hri.global/files/2010/05/31/HIVTop50Documents11.pdf
Walters-Broadway, L. (2012). Effects of trauma on brain function on women and children: Trauma informed practice for advanced clinicians. Proceedings of the trauma and VAW work symposium. Anselma House: Kitchener, Ontario. Retrieved from http://vawforum-cwr.ca/sites/default/files/attachments/proceedings_of_the_trauma_and_vaw_work_symposium_june_15_2012.pdf, pp. 2–3.
World Health Organization (WHO) (2002, January). Defining sexual health. Report of a technical consultation on sexual health (pp. 28–31). Geneva, Switzerland: WHO.
About the Author
Steve K. D. Eichel, PhD, ABPP, CST, ICSA President, is Past-President of the American Academy of Counseling Psychology and the Greater Philadelphia Society of Clinical Hypnosis. He is a licensed and Board-certified counseling psychologist and certified sex therapist whose involvement in cultic studies began with a participant-observation study of Unification Church training in its Eastern seminary (in Barrytown, NY) in the spring of 1975. His doctoral dissertation to date remains the only intensive, quantified observation of a deprogramming. He was honored with AFF’s 1990 John G. Clark Award for Distinguished Scholarship in Cultic Studies for this study, which was published as a special issue of the Cultic Studies Journal and has been translated into several foreign languages. In 1983, along with Dr. Linda Dubrow-Marshall and clinical social worker Roberta Eisenberg, Dr. Eichel founded the Re-Entry Therapy, Information & Referral Network (RETIRN), one of the field’s oldest continuing private providers of psychological services to families and individuals harmed by cultic practices. RETIRN currently has offices in Newark, DE, Lansdowne, PA, Pontypridd, Wales, and Buxton, England (UK). In addition to his psychology practice and his involvement with ICSA, Dr. Eichel is active in a range of professional associations. He has coauthored several articles and book reviews on cult-related topics for the CSJ/CSR.